Healthcare Provider Details

I. General information

NPI: 1588655336
Provider Name (Legal Business Name): KARO INC DBA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/01/2005
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2601 N 3RD ST #125
PHOENIX AZ
85004-1104
US

IV. Provider business mailing address

2601 N 3RD ST #125
PHOENIX AZ
85004-1150
US

V. Phone/Fax

Practice location:
  • Phone: 602-234-2994
  • Fax: 602-234-3162
Mailing address:
  • Phone: 602-234-2994
  • Fax: 602-234-3162

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License NumberOTC 3587
License Number StateAZ

VIII. Authorized Official

Name: MR. DOUG MAXWELL
Title or Position: VICE PRESIDENT
Credential:
Phone: 602-234-2994